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CITY OF ■ PI EASE PRINT RECEIVED MAY 2 0 1999 APPLICATI04'r,0 ILDING PERMIT BUILDLNGDrvisim 33530 First Way South Federal Way, NIA 98003 (253) 661-4000 Fax (253) 661-4129 APPLICATION # ak Site add,.,. T&naawaamne 15C.4+0 L Lot # Assessor's Tax # Building Owner's Name Address -S C,ty F*W t, Zip 6N)003 1Phcne145-5q30- Descripiion of Work-104mt —R�� 2FQP bF-e L�,P�G- Address =RAI Other Phone TRAO k�� . .. . Federal Wiv Rtminp-qq Lirpn-qp # Company Company Name TVz,�N Address City State lzip Contact Person Phone Fax Contractor's # (card must be presented) Expiration Date Verified D Yes 0 No Name �0 Addres moo 'rPzC-M. — C U U -NONE 70' I ISM9 Al Contact Person o N LIN LEGAL DESCRIPTION q74-1-19fol- Please Camel to Reverse -Side IAJ r,: G:nn� <- s; Existing Use Proposed Use Permit includes: Building ❑ Plumbing ❑ Mechanical ❑ Other Type of Work: ❑ Residential ❑ Commercial ❑ New ❑ Addition ❑ Remodel ❑ Re air ❑ # of bedrooms ❑ Garage ❑ Deck ❑ Shed Enter 1 at Floor Area Basement sq ft sq ft 2nd Floor Decks sq ft 3rd Floor sq ft sq ft Garage sq ft Existing Floor Area Proposed Total Area sq ft s ft Water Availability ❑ Sewer Availability ❑ On -Site Septic System Avaifabilily ❑ Peolect Valuation S Q Zoning Lot Size Existing Bld Valuation $ ! For new residential only - Proposed selling cost: $ Name I Address Contractor Name Address City State Zi Contact Phone Fax License # Expiration Date Verified ❑ Yes ❑ No Contractor Name Address City State Zi Contact Phone Fax License # E ration Date Verified ❑Yes L7 No `PLUMh� !t[G:�I�C°�`V1G.[�.Ui►f����e Water Ciosets Sinks Urinals Lawn Sprinklers Bathtubs Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories Washing Machine Drains Total Fixture Caurlt. ; MECHANICAL EVALUATION ONLY $ Fuel Type (aslelectriclothat) Gas Dr er Air Handling { = 10,000 CFM 15-30 Tons Length of Gas Piping Range Air Handlin > = 10,000 CFM 30-50 Tons Furn C100K BTUs Gas Log Unit Heater 50+ Tons Furn > 100 BTUs Fans Miscellaneous Fuel Tanks Gas Hwt Hood Boilers Above Ground Conv Burner Duct Work 0-3 Torts Under round BBQ`s I Wood Stoves 1 3-15 Tons To Unit count DISCLAIMER: I calify under penalty of perjury that the information famished by me is true and correct to the best of my knowledge, and further, that I am authorized by the owner r the above premises to perform the work for which permit application is made. I further agree to save harmless the City of Federal Way as to any claim (including costs, expenscs, and attorneys' fees incurred in investigation and defense of such claim), which my be made by any person, including the undersigned, and filed against the City of Federal Way, but only where such claim arises put of the reliable of the city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of this applieatiom Owner/Agent: Date: r'/ f V, Iq 9U LD-APP REVGEU 6118/99